Important note: Information in this article was accurate in 2005. The state of the art may have changed since the publication date.
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Washington Blade - November 25, 2005
Dyana Bagby
The Centers for Disease Control & Prevention released new information in a conference call with reporters Nov. 17 that showed 157,252 people were diagnosed with HIV between 2001-2004 in the 33 states that have conducted name-based reporting for at least four years.
Of this 157,252 total HIV diagnoses, 44 percent were men who have sex with men, making up the largest proportion of newly reported infections, according to Dr. Ronald Valdiserri, acting director of the CDC's National Center for HIV, STD & TB Prevention. Heterosexuals accounted for 34 percent, while 17 percent were injection drug users, he said.
Overall, the number of HIV diagnoses fell slightly from 2001 to 2004, from 22.8 diagnoses per 100,000 people in 2001 to 20.7 diagnoses per 100,000 in 2004, Valdiserri said. This decrease is driven largely by a 9 percent decline among injection drug users and is partly due to the influence of New York state, which utilizes a state-funded sterile needle program, he said.
And while new infection rates remained relatively stable among men who have sex with men between 2001-2003, data shows an 8 percent increase between 2003 and 2004 among this population across all races, Valdiserri said.
The recent increase in HIV diagnoses among men who have sex with men may reflect reports of increased risky sexual behaviors - such as the use of crystal meth leading to multiple partners - and syphilis, but it may also reflect an increase in HIV testing among gay and bisexual men, Valdiserri said.
"The upturn is consistent with high-risk behavior and the rising rates of syphilis, but we certainly hope this is a reflection of increased HIV testing in this population," he said.
But exactly why a jump occurred between 2003 and 2004 remains unclear, he added.
Gay activists decried federal funding cuts for HIV programs and charged the Bush administration's policies as contributing to new HIV diagnoses.
"No gay or bisexual person can think that HIV/AIDS is no longer a problem for our own community when nearly two-thirds of new infections among males are from men having sex with other men," Matt Foreman, executive director of the National Gay & Lesbian Task Force, said in a prepared statement.
"Clearly, the Bush administration's de-funding, de-prioritizing and de-gaying HIV prevention programs has been nothing short of a disaster and we call upon Congress to act immediately to begin to address this tragedy," Foreman said.
New York included for first time
HIV cases in New York state account for more than 20 percent of all new diagnoses reported during 2001-2004. The addition of New York provides a more representative sample of U.S. diagnoses, but means it is not possible to directly compare the data and trends in this report to earlier reports, Valdiserri said.
"We often say every epidemic is local. We have many sub epidemics going on," said Judy Sackoff, director of surveillance for New York City's Department of Health & Mental Hygiene.
According to figures put out by the department last month, in 2004 approximately 3,700 New Yorkers were diagnosed with HIV, a decline of 11 percent from the previous year. The largest decrease was in Hispanic women at 25 percent, and white men declined by 14 percent.
In the category termed MSM (men who have sex with men), city numbers were stable but once race was factored in the figures told a more complicated story.
"Among black MSMs, we saw a significant increase, while in white MSMs there was a decline and Latino MSMs were relatively flat," Sackoff said.
More than half - or 51 percent - of the new HIV diagnoses between 2001-2004 were among African Americans, said Dr. Lisa Lee, a senior epidemiologist in the CDC's Division of HIV/AIDS Prevention. In 2004, the rate among blacks was 8.4 percent higher than among whites.
A CDC study released earlier this year noted 46 percent of black men who have sex with men in five cities were HIV positive. The survey included data from Baltimore, Los Angeles, Miami, New York City and San Francisco.
"HIV continues to exact a tremendous toll on men who have sex with men of all races, especially men who have sex with men of color," Valdiserri said.
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James Withers contributed to this report.
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